Provider Demographics
NPI:1811396153
Name:BREKKE, SARAH (ASW)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:BREKKE
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22455 MAPLE CT
Mailing Address - Street 2:SUITE 402
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94541-4031
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22455 MAPLE CT
Practice Address - Street 2:SUITE 402
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94541-4031
Practice Address - Country:US
Practice Address - Phone:510-582-0148
Practice Address - Fax:510-582-8460
Is Sole Proprietor?:No
Enumeration Date:2014-08-21
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW622451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical